Individual
MOHAMMAD THEIB ASSAF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6005 PARK AVE, SUITE # 722B, MEMPHIS, TN 38119-5202
(901) 683-8448
(844) 203-0802
Mailing address
PO BOX 1616, CORDOVA, TN 38088-1616
(901) 683-8448
(901) 683-8558
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
13794
MS
174400000X
Specialist
Primary
MD0000027300
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00114404
—
MS
Enumeration date
08/05/2006
Last updated
09/25/2024
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